Nonsuicidal self-injury (NSSI) is one of the most horrifying behaviors for parents to witness in their child. Deliberate self harm is almost always a sign of a serious underlying mental health condition and it can be a way for a child to cope with difficult emotions or situations.
NSSI usually starts in adolescence and is more common in girls than boys. As many as one in four girls self-injures, according to a recent 2018 survey. However, it is important to remember that anyone can engage in self harm, regardless of age, gender, or background. If you are worried about someone engaging in nonsuicidal self-injury, this article will help you understand the difference (and similarities) between both, as well as the warning signs and how to get help.
What is NSSI?
NSSI stands for nonsuicidal self injury, or nonsuicidal self harm, which is defined as the deliberate, self-inflicted damage to one’s own body tissue without the intention of suicide. Self harming behaviors can include anything that hurts and causes physical pain, including but not limited to:
- Cutting
- Burning
- Hitting or punching oneself
- Banging or hitting one’s head against a hard surface
- Intentionally preventing wounds from healing/picking scabs
- Swallowing poisonous substances or objects
- Interfering with the healing of bones
These are just some examples of self injurious behaviors – the list is not exhaustive. It’s important to remember that any type of deliberate self-injurious behavior can be classified as NSSI.
Nonsuicidal self-injury is often seen as a cry for help, and/or a way to cope with difficult emotions or situations. It is usually a sign of an underlying mental health condition, such as depression, anxiety, post-traumatic stress disorder (PTSD), borderline personality disorder (BPD), or eating disorders.
Why Do People Self-Harm?
Understanding nonsuicidal self-injury (NSSI) can be difficult for parents. The risk factors and warning signs are crucial for parents to understand. Most people who self-harm do so as a way to cope with difficult emotions or situations. It can be a form of self-punishment or a way to release pent-up anger, anxiety, or frustration. In fact, studies have shown that most people who self harm experience a negative event beforehand, and use self injury as a way to feel release. For some people, it may provide a sense of relief from the emotional pain they are feeling.
For those who self-injure as a form of self-punishment, there may be a higher risk of suicidal behavior. For instance, if a person is a victim of childhood sexual abuse, the trauma might lead to shame and hatred directed toward oneself. If you believe that your or your loved one’s nonsuicidal self-injury is leading to suicidal behavior or suicide attempts, get help immediately.
People who cannot regulate their emotions effectively are more likely to self-harm. This is because they may not have other healthy coping mechanisms in place, and may turn to NSSI as a way to deal with their feelings. For many of these teens, self harm can feel compulsive and unavoidable.
Some reasons young adults might have trouble regulating their emotions include:
- Learning to hide their emotions
- Not being able to express their feelings openly
- Being afraid of appearing weak or vulnerable
- Feeling like they have to be perfect
- Not having a strong support system
- Experiencing trauma or abuse
- Mental health disorders like borderline personality disorder
Understanding that NSSI or nonsuicidal self injury is usually a sign of an underlying mental health condition is crucial. If your child is self cutting or exhibiting other self injurious behavior, they are likely experiencing a lot of pain, and are using nonsuicidal self injury as a way to cope with those feelings. It is important to get them help from a mental health professional as soon as possible, so your child can get the help they need.
What are the Warning Signs?
Most people who self-injure will show some warning signs beforehand. Some signs that parents can look out for include:
- Hiding their arms or legs
- Wearing long sleeves or pants in hot weather
- Avoiding social situations
- Isolation from friends and family
- Giving away prized possessions
- Making comments about self harm
- Having trouble regulating emotions
Any of these signs could indicate that your child is self-harming. If you are worried about your child, it is important to talk to them about your concerns. It is also important not to pressure or shame them into opening up – this will only make them feel worse. However, the sooner you pay attention and get your child help for their NSSI, the lower the chances are of them committing suicide.
What’s the Difference Between NSSI and Suicide?
The main difference between NSSI and suicide is intention. While it doesn’t seem like it, most people who engage in NSSI do not have suicidal intent – they are harming themselves as a way to cope with pain, and not as a way to end their life.
However, NSSI can sometimes lead to suicide. This is because the line between NSSI and suicide is often blurry, and it can be hard to tell which one is which. For instance, someone might cut themselves and then have thoughts about wanting to die. Or, they might not have the coping skills to deal with stress, and as a result, turn to self-harm or suicide. In this case, it is essential to get help right away, as the person may be at risk of harming themselves further or attempting suicide.
If you are worried that your child is engaging in NSSI or other self-harming behavior or may be considering suicide, contact a mental health professional, such as a therapist or counselor, who can assess the situation and provide guidance on how to best help your child. You can also call a suicide hotline in your area – they will be able to talk to you about your concerns and connect you with resources in your area.
Additionally, people who engage in NSSI are at a higher risk of attempting suicide later on, with adolescents having an even greater risk of suicide if they have attempted suicide before.
If you think your child may be suicidal, there are some warning signs you can look out for, including:
- Talking about wanting to die or hurt themselves
- Expressing feelings of hopelessness
- Talking about being a burden to others
- Increasing alcohol or drug abuse
- Withdrawing from friends and activities
- Unusual mood swings
- Giving away prized possessions
- Sudden changes in behavior, such as becoming more aggressive or withdrawn
All of these signs of suicide should be taken seriously, whether or not your child is showing NSSI or not.
Best Treatment for NSSI
Researchers are now looking for the best treatment methods for both treatment-resistant depression and nonsuicidal self-injury, which often go hand in hand. They’ve found that certain forms of therapy can help in treating nonsuicidal self-injury, including:
- Problem-solving CBT: This type of therapy helps people with depression identify and change negative thinking patterns.
- Interpersonal CBT: This therapy helps people with depression understand and improve their relationships with others.
- Dialectical behavioral therapy (DBT): This type of therapy, which is often used to treat borderline personality disorder, can also be helpful for people who self-harm. It teaches skills like emotion regulation and distress tolerance.
- Acceptance and commitment therapy (ACT): This type of therapy helps people accept their thoughts and feelings without judging them. It also teaches people to commit to taking action in line with their values, even if it’s difficult.
While no two children and teens are alike, and what works for one may not work for another, these types of therapies have been shown to be effective in treating both depression and self harm.
If you are concerned about your child’s NSSI, it is important to seek professional help. A mental health professional can assess your child’s symptoms and develop a treatment plan that is tailored to their needs.
How To Talk To Teens About NSSI
If your teen is engaging in nonsuicidal self-injury, it might be tough to get them to admit it, let alone talk about it. Here are some tips for how to approach the subject:
Listen without judgment
It’s important that your teen feels heard and understood, without being judged. Avoid giving lectures or lectures, and instead, try to understand why they are turning to deliberate self-injury.
Empathize with their pain
Show your teen that you understand how much pain they must be in to hurt themselves. Let them know that you want to help them find other ways to cope with their pain.
Offer support and resources
If your teen is ready to talk about their NSSI, offer them support and resources, such as therapy, a support group, or a hotline. Help them develop a safety plan to use if they feel like harming themselves again or are thinking about a suicide attempt.
Encourage healthy coping mechanisms
Help your teen find healthy ways to cope with their intense negative emotions, such as exercise, journaling, or talking to a friend. Encourage them to avoid using NSSI as a way to cope with their pain.
Teach them that expressing emotions is okay
As mentioned earlier, many people who self-harm do so because they’re unable to express their emotions. Teach your teen that it’s okay to feel sad, angry, or scared, and help them find healthy ways to express their emotions.
Get Your Teen Help For NSSI Today
While deliberate self-harm syndrome doesn’t always lead to suicide attempts, it’s a dangerous problem indicative of serious mental health issues that should not be ignored. If you are concerned about your teen’s NSSI, don’t hesitate to get them help from a mental health professional.
At Clear Behavioral Health, our teen program is designed to help adolescents of all backgrounds treat depression and other mental health disorders. Our program offers a variety of evidence-based therapies, such as CBT, DBT, and ACT, that have been shown to be effective in treating both depression and self-harm. Contact us today to learn more about our program and how we can help your teen develop the skills they need to love themselves!
